An Alternative Aortotomy Technique for Aortic Valve Replacement in Porcelain Aorta

Abstract

Porcelain aorta is extensive calcification of the ascending aorta that can be completely or near completely circumferential. Here we report a case of severe aortic stenosis and left anterior descending coronary osteal stenosis in a patient with a porcelain aorta. In this paper an alternative aortotomy approach; reverse “T” letter aortotomy incision is described for Type IB porcelain aorta. Patient underwent aortic valve replacement in addition coronary bypass grafting via sternotomy. The surgery and the postoperative course were uneventful and she was discharged at 7th day. This aortotomy technique prevents unnecessary and risky manipulations of extensive calcificated porcelain aorta, provides perfect exposure, and can be closed securely via dacron patch after aortic valve surgery. By the help of the described aortotomy technique, AVR can be the preferred choice in patients with porcelain aorta and multiple cardiac comorbidities requiring additional procedures, such as coronary bypass.